CD4 T-cells & HIV
CD4 is a glycoprotein found on the surface of immune cells such as T helper cells, monocytes and macrophages
cells. CD4 cells (sometimes called T-cells, T-lymphocytes, or helper cells) are
white blood cells that play an important role in the immune system. Your CD4
cell count gives you an indication of the health of your immune system – your
body’s natural defence system against pathogens, infections and illnesses.
CD4 T-cells are
considered "helper" cells because they do not neutralize infections
but rather triggers the body's response to infections. In response, CD8
T-cells—classified as such because of the type of glycoprotein on
their surface—play a part as so-called "killer" cells by producing
antiviral substances (antibodies) that help fight off foreign invaders.
Structure of CD 4
cells:
Like many cell surface receptors/markers, CD4 is a member of
the immunoglobulin super family
It has four immunoglobulin
domains (D1 to D4) that are exposed on the extra cellular surface of the cell:
- D1 and D3 resemble immunoglobulin variable (IgV) domains.
- D2 and D4 resemble immunoglobulin constant (IgC) domains.
CD4 uses its D1 domain
to interact with the β2-domain of MHC class II molecules. T cells expressing CD4 molecules (and not CD8) on their surface,
therefore, are specific for antigens presented by MHC II and not by MHC class II (they are MHC class II-restricted). MHC class I contains Beta-2 macroglobulin.
How HIV Affects CD4
Cells:
As a retrovirus, HIV do not have
own enzymes necessary for protein & nuclic acid synthesis and so depend
upon synthetic machinery oh host cells. Therefore, HIV needs to infect certain
"host" cells in order to make copies of itself. CD4 cells are the
prime targets for this in the course of an infection.
During infection, HIV attaches to
surface of CD4 cells, emptying its genetic material within so that the host's
genetic coding can be altered to produce other HIV virions.
How Do We Measure CD4 T-Cells
By determining how many
functioning CD4 cells are circulating in the blood, a doctor can determine the
status of a person's immune system. A simple blood tested called the CD4 COUNT estimates the number of functioning CD4 cells in a cubic millimetre of
blood. The higher the CD4 count, the stronger the immune function.
Your CD4 cell count is the
measurement of the number of blood cells in a cubic millimeter of blood (a very
small blood sample). It is not a count of all the CD4 cells in your body.
- The CD4 cell count of a person who does not have HIV can be anything between 500 and 1500.
- People living with HIV who have a CD4 count over 500 are usually in pretty good health.
- People living with HIV who have a CD4 cell count below 200 are at significant risk of developing serious illnesses. While HIV treatment is recommended for all people living with HIV, it is especially important for people with low CD4 counts.
If you have HIV and do not take
HIV treatment, your CD4 count will fall over time. The lower the CD4 cell
count, the greater the damage to the immune system and the greater the risk of
illness.
When you take HIV treatment, your CD4 count should gradually
increase
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